Name

Choriorétinopathie séreuse centrale se présentant comme un syndrome d'effusion uvéale

To discuss the relationships between Central Serous Chorioretinopathy (CSCR) and Uveal Effusion Syndrome (UES) based on the cases of 3 patients presenting with common aspects to both entities.

Retrospective review of the files of 3 patients. 4 eyes were initially diagnosed with idiopathic UES. All eyes underwent ultrasonography (US), axial length (AL) measurement, fluorescein (FA) and ICG angiography (ICGA), Optical Coherence Tomography (OCT), and orbital Magnetic Resonance Imaging (MRI). Follow-up was minimum 5 years. Clinical charts, surgical procedures and outcomes were retrospectively assessed and compared. A literature review was conducted using the MEDLINE and Web of Science databases. It aimed to find previous association between uveal effusion and CSCR. 

The 3 patients (4 eyes) presented with annular ciliochoroidal detachment and exudative inferior bullous retinal detachment in addition with signs of chronic CSCR at diagnosis or a history of chronic CSCR. Steroids uptake triggered or worsened the condition in the 3 patients. Affected eyes displayed several subretinal leaking points in fluorescein angiography (FA) which are not usually seen in UES. Subretinal yellowish deposits led to a negative leopard-spot pattern best seen on FA in the three patients. ICG angiography showed dilated choroidal veins and areas of choroidal hyperpermeability. OCT and US revealed a significant choroidal thickening in affected and other eyes. MRI and US confirmed the annular ciliochoroidal detachment seen in fundus. Three eyes out of four were successfully treated by posterior sclerectomies. In the latter, exudation progressively resolved after photodynamic therapy.

A literature review points out numerous similarities between UES and CSCR such as suprachoroidal and subretinal fluid accumulation, choroidal hyperpermeability, pachychoroid, thickened sclera, short axial length, leopard-spot pigmentary changes. However, CSCR is usually considered as a differential diagnosis of UES.

We report the cases of 3 patients (4 eyes) presenting with inferior bullous RD associated with annular choroidal detachment simulating an idiopathic effusion uveal syndrome but presenting either a history of CSCR in the same eye or signs of pachychoroid disease in the fellow eye. The frontiers between the two entities could be questioned.